Dr Voss Gibson•
Introduction to Artemether Lumefantrine
Artemether lumefantrine is an artemisinin-based combination therapy (ACT) approved for treating acute uncomplicated malaria. It pairs fast-acting artemether with longer-lasting lumefantrine to ensure complete parasite elimination. Widely recommended by the WHO, it's essential for managing chloroquine-resistant strains.
Overview of Coartem as an Antimalarial
Coartem tablets contain 20 mg artemether and 120 mg lumefantrine, available in scored, dispersible forms for children. It's not for prophylaxis but excels in treatment, with cure rates over 95% in clinical trials. The TGA lists it for falciparum malaria in Australia [1].
History and WHO Recommendations
Developed in the 1990s, artemether lumefantrine gained WHO endorsement in 2001 as a first-line ACT. By 2025, innovations like infant formulations expand access in endemic areas. It's now standard in over 80 countries, reducing global malaria deaths [2].
How Does Artemether Lumefantrine Work?
This duo attacks malaria parasites at different life stages for synergistic efficacy.
Mechanism of Action: Rapid Parasite Clearance
Artemether, derived from artemisinin, generates free radicals that damage parasite proteins and membranes, clearing blood-stage infections quickly. Lumefantrine inhibits heme detoxification, preventing parasite survival in red blood cells. Together, they reduce parasitemia by 90% within 24 hours [3].
Role in Combination Therapy
ACTs like artemether lumefantrine combat resistance by using short-half-life artemether for initial kill and lumefantrine's 3–6 day persistence for mop-up. This delays resistance emergence, per WHO guidelines [4].
Efficacy Against Drug-Resistant Strains
Effective against chloroquine- and sulfadoxine-pyrimethamine-resistant P. falciparum, with low recrudescence rates. Studies confirm 28-day cure rates of 95–100% in Africa and Asia [5].
Uses of Artemether Lumefantrine
Primarily for therapeutic intervention in non-severe malaria.
Treating Uncomplicated Falciparum Malaria
Indicated for adults and children over 5 kg with fever and parasitemia without organ dysfunction. It resolves symptoms within 48 hours, shortening hospital stays [6].
Suitability for Children and Adults
Safe from 2 months old; dispersible tablets ease pediatric dosing. Weight-based regimens ensure efficacy across ages, with no pediatric-specific issues noted [1].
Not for Prevention or Severe Cases
Not prophylactic; use atovaquone-proguanil instead. For severe malaria, opt for IV artesunate. Australian travelers should confirm via pre-travel consults [7].
